Blood Glucose Monitoring, Case Study Example

Introduction

The blood glucose test strip/ monitoring in mainly used in situations when the blood glucose level is not within the normal range which is (4-7 mmol/litre) the test is primarily used to manage and monitor the treatment of both types of diabetes. The insulin- dependent diabetes mellitus and the non-insulin –dependent diabetes mellitus are tested and closely monitored using this blood control test / monitoring mechanism. The procedure has been performed according to the set standards by NHS litigation Authority Risk Management (2008) for all the clinical diagnostic tests.

Target group

This monitoring procedure target mainly the assistant practitioners, nursing Auxiliaries, all the nurses registered and employed by Wirral PCT and those who have successfully taken the required unit that is within the NVQ level three that is meant to monitor blood glucose as indicated in the job description.

Policies/ principles and purpose of the lab procedure

Some of the main reason why the lab procedure had to be put in place is to:

• For nursing and midwifery purposes
• For record keeping for community nursing
• For infection control policies and
• Sharpening usage and disposal policies
• To set the standards for conduct, performance and ethics for blood glucose monitoring

Blood glucose monitoring procedure

Required equipment

• Test strips
• Blood glucose monitor
• Quality control/ record book
• Quality control solution
• Finger prick device
• Vinyl gloves

Poor glucose control

In the event that glucose control fails, the patient is likely to develop clinical complications of diabetes. This is common with those patients whose blood glucose where poorly controlled blood glucose. Some of the commonly known complications include but not limited to ischemic heart disease and some renal and eye diseases.

In the event that these complications develop as a result of control, there is need to take precautionary and curative measures like reducing the patient’s average hemoglobin A1c (HbA1c) level. This according to the United Kingdom Prospective Diabetes Study (UKPDS) reduces the risk of for acute complications. This is a curative measure but in order to prevent such failures of blood glucose control, adequate training should be trained to be competent in the use of monitor. These include having underpinning knowledge on how to advise the patient accordingly. One should also understand the patient’s type of diabetes and the control measures for the disease. In the event of the control, nurse administering the patient should always be guided by the diagnosis and treatment decisions based on confirmed laboratory results and the provided steps to take in the event of control failure.

Extra points/ competences to consider

Some of the other extra points to be put into consideration while undertaking blood glucose testing include but not limited to;

• Washing hands before handling the instrumentations
• Recapping vial after removing glucose test strips
• Orienting the Nova Max glucose test strip into the glucometer correctly
• Maintaining the hygienic standards when obtaining blood for applying lancet
• Discarding the first drop of blood in case of a wound and applying the second droplet to edge of the test strip
• Removing properly and discarding the used test strip.

Below are some of the recent advances that have been made in blood glucose monitoring include

1. 1. Alternate site testing -The use of blood drops from other places other than finger
2. No coding systems- To help avoid miscoding
3. Multi-test results – To avoid loading individual strips every time
4. Downloadable meters – This involves use of computer to download meter results
5. Disposable glucose sensor – Worn For some days until replacement
6. An electronic receiver – Displays glucose levels with clear continuous updates with clear monitoring of raising and falling trends